1. Field of the Invention
The present invention relates to management, display and information presentation and decision-support systems used to improve attention allocation, situation awareness, problem solving and decision making during management of patient's cardiovascular and ventilation systems and during administration and management of patient's medications and fluids.
2. Description of the Prior Art
Human error results when available resources of the clinician, such as knowledge, skills, and strategies, are inadequate for the demands of the situation. In medicine, monitoring equipment and their displays extend the physician's resources but at the expense of additional cognitive demands. Clinicians' abilities to meet the demands of critical decision making during management of patient's cardiovascular system and during administration and management of patient's medication and fluids depend not only on their internal resources, but also on the displays through which they perceive the situation. Although some patient and equipment indicators are observed and measured directly by the clinician, increasing, the data used to diagnose and correct critical situations are measured and displayed by medical equipment.
Most medical informational displays are traditional, in that they are based on the one-sensor/one-indicator technology. Research in other domains has shown that such display design is not compatible with the capabilities of the human perceptual system, and may hinder data transmission from the machine to the human. Traditional numeric and meter displays do not take advantage of people's inherent ability to understand patterns and shapes. During routine and problem-solving situations, the human must scan many displays to collect relevant data. Traditionally, data is displayed in a single format, even though the relevance of the data changes with the goals of the situation. Traditional displays have high attention demands since insignificant information may be prominent while important data are pushed into the background. Since traditional displays do not directly display the high-order state of the system, the clinician problem-solver must deduce system state by processing raw data, in the form of machine-sensed variables, directly-sensed indicators, and situational cues. Furthermore, the functional relationships among the various elemental display elements are not represented and calculations are sometimes required to derive such high-order state properties. Traditional displays require considerable effort and knowledge which may exceed the human's capabilities or the time available for effective action.
In other complex domains, new management and display systems, called ecological interface systems, have been developed to reduce human error and support the clinician's attentional and problem solving and decision-making demands. Ecological Interface Design (EID) has been proposed as a method for creating human-machine equipment that make work processes more visible and aid the human during complex management and problem-solving situations. In ecological interface systems, elements are organized to show inter-relationships among system variables. The interface is organized in two dimensions: abstraction hierarchy and system decomposition. In the abstraction hierarchy, the highest level contains operator goals, middle levels represent system functions, and the lowest level specifies the system's controls and physical form. In system decomposition, the highest level represents the whole system, middle levels describe subsystems, and the lowest level deals with components. Thus, the system contains controls and representations of everything the operator needs to consider in performing his or her work, from abstract goals to physical actions, whether dealing with the entire system or considering specific components.
Ecological interface systems present the operator with a complete set of the goals to be achieved in managing the system, the rules or the constraints that govern these goals, and the low-level variables or data that are processed by these rules. By making system processes visible, ecological interface systems support various tasks, such as process control, safety monitoring, and fault diagnosis. Safety monitoring is performed high in the abstraction dimension to detect violated goals. Fault diagnosis is accomplished by moving down the abstraction hierarchy, along the paths of violated goals, to detect the rules that have been broken. Further down the hierarchy are the controls or variables to be manipulated in order to correct the event. Ecological interface systems have been utilized in nuclear and petrochemical process applications, but have not been widely used and applied to medical systems. In this patent application, we apply the EID principles to design a system for management of patient's cardiovascular and ventilation system and for the administration and management of patient's medications and fluids.